Noninvasive Ventilation in COPD

Dreher, Michael; Ekkernkamp, Emelie; Walterspacher, Stephan; Walker, David; Schmoor, Claudia; Storre, Jan Hendrik; Windisch, Wolfram

doi:10.1378/chest.11-0253

Cited by 86 publications

(24 citation statements)

References 27 publications

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“…MV was defined as the product of tidal volume and respiratory rate (RR). Full polysomnography (PSG; SOMNOscreen™ plus, Somnomedics GmbH, Randersacker, Germany) was used to objectively assess sleep quality as described previously [12]. Subjective sleep quality and comfort with NPPV were assessed using 100-mm visual analog scales (VAS) as follows.…”

Section: Methodsmentioning

confidence: 99%

“…The primary outcome parameter, the difference in time spent in N3/4 sleep, was used to determine the minimum sample size required to ensure adequate power to detect an effect of the interventions. Assuming a power (β) of 90% with an α of 0.05 to detect a 10% change in N3/4 sleep (with an SD of 10%) according to previous findings, at least 13 patients were needed for the analysis [3,12]. The paired t test was used for the comparison of iVAPS and HI-NPPV.…”

Section: Methodsmentioning

confidence: 99%

“…This is in contrast to the technique of HI-NPPV, which aims to achieve a controlled type of NPPV [10,11,12]. Despite these differences, iVAPS has been shown to be as effective as conventional pressure support ventilation for stable hypercapnic COPD patients with respect to daytime blood gases and mean nocturnal oxygen saturation [13].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

et al. 2014

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Background: Noninvasive positive-pressure ventilation (NPPV) using intelligent volume-assured pressure support (iVAPS) combines volume- and pressure-preset NPPV and therefore uses a variation of inspiratory positive airway pressures. Objectives: The effect of iVAPS on sleep quality in stable hypercapnic patients with chronic obstructive pulmonary disease (COPD) has not been determined. Methods: In this randomized, open-label, two-treatment, two-period, crossover study, patients were randomized to receive high-intensity (HI)-NPPV and then iVAPS or iVAPS and then HI-NPPV. Patients were studied in hospital for 2 consecutive nights, employing full polysomnography (PSG), transcutaneous partial pressure of CO₂ (PtcCO₂) monitoring, blood gas analysis and a visual analog scale (VAS)-based sleep questionnaire. After discharge, patients used HI-NPPV and iVAPS at home, each for 6 weeks. They had to answer a VAS question concerning sleep every morning, and were telephoned weekly and asked additional questions. At the end of each treatment period, they were visited at home for the determination of blood gases and treatment adherence, and to change the NPPV mode. Results: Fourteen patients were enrolled. In-hospital PSG measurements showed no difference in sleep quality between iVAPS and HI-NPPV. At home, patients reported more restful sleep during iVAPS than HI-NPPV (p = 0.04). Blood gases during spontaneous breathing at home did not differ with iVAPS and HI-NPPV, and there was a greater decrease in PtcCO₂ during iVAPS than during HI-NPPV (p = 0.003). Conclusion: Although sleep quality in hospital was not different between iVAPS and HI-NPPV, COPD patients with chronic hypercapnic respiratory failure reported a trend towards more restful sleep at home with iVAPS. In addition, nocturnal hypercapnia was effectively treated with iVAPS.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

et al. 2014

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“…Overall, dropout during noninvasive mechanical ventilation remains a serious clinical problem 4. This study provides valuable information in this regard, suggesting that sufficiently high-pressure delivery is enough to achieve useful clinical and physiological goals.…”

Section: Dear Editormentioning

confidence: 87%

Noninvasive mechanical ventilation with high pressure strategy remains a “double edged sword”?

Esquinas

Siscaro

Clini

2013

COPD

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“…Insbesondere bei einer Beatmung mit hohen Beatmungsdrücken ("high intensity non-invasive positive pressure ventilation", HI-NPPV) muss demnach auf eine Reduktion mögli-cher Leckagegeräusche geachtet werden. Dagegen ließ sich nachweisen, dass eine Erhöhung der Beatmungsdrücke per se nicht mit einer Verschlechterung der Schlafqualität einhergeht [14,15,48].…”

Section: Schlafqualitätunclassified

Schlaf- und Lebensqualität in der außerklinischen Beatmung

et al. 2017

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Noninvasive Ventilation in COPD

Cited by 86 publications

References 27 publications

Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

Noninvasive mechanical ventilation with high pressure strategy remains a “double edged sword”?

Schlaf- und Lebensqualität in der außerklinischen Beatmung

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Noninvasive Ventilation in COPD

Cited by 86 publications

References 27 publications

Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

Impact of Intelligent Volume-Assured Pressure Support on Sleep Quality in Stable Hypercapnic Chronic Obstructive Pulmonary Disease Patients: A Randomized, Crossover Study

Noninvasive mechanical ventilation with high pressure strategy remains a &ldquo;double edged sword&rdquo;?

Schlaf- und Lebensqualität in der außerklinischen Beatmung

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Noninvasive mechanical ventilation with high pressure strategy remains a “double edged sword”?